Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Cutaneous Reactions after COVID-19 Vaccines – Analysis of the Clinical and Histological Spectrum – Case Series and Review of the Literature

Ursina Schmid
ORCID logo ,
Jörg Galambos MD
,
Katrin Pfaltz MD
,
Ivan Hegyi MD
,
Salomé Courvoisier MD
,
Werner Kempf Prof. MD
*
Version 1 : Received: 30 December 2023 / Approved: 3 January 2024 / Online: 3 January 2024 (05:39:23 CET)

A peer-reviewed article of this Preprint also exists.

Schmid, U.; Galambos, J.; Pfaltz, K.; Hegyi, I.; Courvoisier, S.; Kempf, W. Cutaneous Reactions after COVID-19 Vaccines: Analysis of the Clinical and Histopathological Spectrum—Case Series and Review of the Literature. Dermatopathology 2024, 11, 130-141. Schmid, U.; Galambos, J.; Pfaltz, K.; Hegyi, I.; Courvoisier, S.; Kempf, W. Cutaneous Reactions after COVID-19 Vaccines: Analysis of the Clinical and Histopathological Spectrum—Case Series and Review of the Literature. Dermatopathology 2024, 11, 130-141.

Abstract

(1) Background: Various cutaneous adverse drug reactions (ADRs) are observed with the development of mRNA COVID-19 vaccines. To gain insight into the clinicopathologic features, we analyzed the correlation of histological and clinical data in 48 patients with these ADRs.; (2) Methods: Single-center retrospective study in patients with ADRs post-mRNA COVID-19 vaccination (mRNA-1273 and BNT162b2 vaccines).; (3) Results: Distant generalized ADRs prevailed (91%), often appearing clinically as spongiotic dermatitis or maculo-papular exanthema. Histopathological analysis revealed spongiotic changes (46%) and dermal superficial perivascular lympho-histiocytic infiltrates (17%). Eosinophils were found in 66% of biopsies, neutrophils in 29%, and plasma cells only in 8% of biopsies. Most ADRs occurred post-second vaccine dose (44%). Histologically spongiotic changes were associated with clinical features of spongiotic dermatitis in only 50% and maculo-papular exanthema in the remaining patients. ADRs represented an aggravation of preexisting skin disease in 23% of patients. ADRs regressed within 28 days or less in 53% of patients and persisted beyond a month in the remaining patients.; (4) Conclusions: Our study demonstrates a diverse spectrum of generalized ADRs, revealing correlations between histology and clinical features but also instances of divergence. The majority of ADRs are self-limited with a few extending beyond a month.

Keywords

cutaneous; adverse; COVID-19; vaccine; histology; clinicopathologic correlation

Subject

Medicine and Pharmacology, Dermatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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